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Job Description

Job Responsibilities

At Alliance HealthCare Services, our focus is on transforming the customer and patient experience. Vital to our success are the Corporate Team Members who collaborate with clinical, operational, and sales teams in the field. We focus on delivering improved processes, innovative new services, and business solutions that differentiate and advance our comprehensive clinical services—always with our patients’ and customers’ needs in mind.

The Manager of Government Enrollment and Physician Credentialing will supervise all aspects of Alliance Healthcare Services government healthcare provider enrollment and physician/physicist credentialing programs. The primary responsibility of the Manager of Government Enrollment and Physician Credentialing is to ensure that Alliance Healthcare Services is in 100% compliance with all Medicare and Medicaid regulations and timely filing requirements. The Team Member in this position is the guardian of the Alliance Healthcare Services active Medicare and Medicaid certifications with the responsibility for ensuring that there is never a time when Alliance Healthcare Services is in jeopardy of having any certification revoked or terminated. This is a corporate level task that requires the Manager of Government Enrollment and Physician Credentialing to work directly with all other Alliance Healthcare Services departments and divisions to provide the requisite information needed to complete initial and revalidation applications accurately and within the timeframe required by Medicare and Medicaid. In the event Medicare or Medicaid sends back a development request, the Manager of Government Enrollment and Physician Credentialing will ensure accurate and timely responses that include engaging the legal department to develop an appeal when Alliance Healthcare Services disputes the position Medicare or Medicaid is taking related to any particular regulation. This position supervises the Team Members who complete the Alliance Healthcare Services provider enrollment applications, revalidations and updates for governmental healthcare programs, including Medicare and Medicaid. The role is responsible for ensuring that all Alliance Healthcare Services independent diagnostic testing facilities (“IDTFs”) pass onsite inspections by Medicare and State Medicaid inspectors in order to remain compliant with the IDTF performance standards and other Medicare/Medicaid requirements. The Manager develops precise and rigorous training materials and training programs for newly hired team members. When there are significant changes to either the Medicare or Medicaid regulations or a change to the Alliance Healthcare Services ownership structure, the manager prepares training materials and specific training programs for all internal staff including the Manager’s direct reports, Business Development, Sales, and Operations on the issues and their impact to the IDTF site operations. The Manager of Government Enrollment and Physician Credentialing is the subject matter expert on Medicare and Medicaid regulation and acts in the capacity of being a resource to others in the company.

The Manager also has responsibility for the physician and physicist credentialing for all locations, retail, wholesale, RAD360 and Oncology. This positions manages all physician and physicist credentialing activities including policy development, oversight of the source verification qualifications and management of the credentialing committee to stay in compliance with the Joint Commission standards. On a monthly basis, the Manager will track upcoming license and insurance expirations to ensure all physicians and physicists remain eligible to perform services on behalf of Alliance. The Manager ensures all credentialing files are complete, accurate and available in order to comply with Joint Commission audits.

The Manager of Government Enrollment & Physician Credentialing is responsible for the implementation of the systems and processes necessary to support efficient and effective activities within the Government Enrollment and Physician Credentialing department. This includes developing and using tracking reports to monitor department and individual Team Member results to ensure key performance indicators are met each month.

Specific duties include, but are not limited to:

Leads all aspects of the Government Enrollment and Credentialing department including process improvement initiatives and implementation of processes to improve efficiency and effectiveness of the team. Meets or exceeds all personal and department Key Performance Indicators (KPI’s).

Oversees the 100% accurate and 100% timely compliance of government provider enrollment applications and updates, as well as ensures that IDTF inspections are passed and IDTF performance standards and other Medicare/Medicaid requirements are compliant.

Ensures that the Physician Credentialing team is implementing and following all policies and procedures to ensure efficiencies and compliance with the Joint Commission standards for physician and physicist credentialing.

Provides direction and training to staff to ensure department meets production and quality assurance goals defined for this position. Provides assistance to other Alliance departments and works closely with the Legal department in developing communication and training with respect to Medicare and Medicaid regulations.

Responsible for oversight of all Medicare and Medicaid regulations including staying abreast of new guidelines and their ramifications to Alliance as well as developing new policies and procedures to support new or changing regulations.

Position Requirements

Bachelor’s degree from an accredited college or university in Healthcare, Business Management or Public Health Administration required in addition to seven (7) to eight (8) years of equivalent work experience required.

Minimum of two (2) years of management experience with physician and physicist credentialing.

A division of Alliance HealthCare Services (NASDAQ: AIQ), we are an equal opportunity employer and we believe in strength through diversity. All qualified applicants will receive consideration for employment without regard to, among other things, race, religion, color, national origin, sex, sexual orientation, gender identity & expression, status as a protected veteran, or disability.

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Alliance HealthCare Services

Alliance has the expertise and industry-leading resources to provide radiology or radiation oncology solutions for our partners, including market analysis, strategic planning, management and staffing, state-of-the-art equipment, and marketing. We strive to be the premier provider of diagnostic radiology and oncology services in the nation. We focus on MRI, PET/CT, and CT and other advanced diagnostic modalities through our Radiology division and radiation therapy through our Oncology division. With approximately 1,800 team members committed to providing exceptional patient care and exceeding customer expectations, Alliance provides quality clinical services for over 1,000 hospital and other health care partners in 43 states. Alliance (NASDAQ: AIQ) is a NASDAQ listed company. We have excellent financials showing consistent growth in EBITDA, a strong balance sheet, and a very strong foundation to support future growth, including a stable and experienced management team.